Provider Demographics
NPI:1184282758
Name:LIVING INDEPENDENTLY FOREVER INC.
Entity type:Organization
Organization Name:LIVING INDEPENDENTLY FOREVER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-418-5666
Mailing Address - Street 1:550 LINCOLN ROAD EXT
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-6233
Mailing Address - Country:US
Mailing Address - Phone:508-418-5666
Mailing Address - Fax:508-778-4919
Practice Address - Street 1:550 LINCOLN ROAD EXT
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-6233
Practice Address - Country:US
Practice Address - Phone:508-418-5666
Practice Address - Fax:508-778-4919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-30
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty